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[House Report 111-638]
[From the U.S. Government Publishing Office]


111th Congress  }                                            {   Report
  2d Session    }             HOUSE OF REPRESENTATIVES       {  111-638
=======================================================================
 
          ARTHRITIS PREVENTION, CONTROL, AND CURE ACT OF 2010 

                                _______
                                

 September 28, 2010.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

         Mr. Waxman, from the Committee on Energy and Commerce,
                        submitted the following

                              R E P O R T

                        [To accompany H.R. 1210]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 1210) to amend the Public Health Service Act to 
provide for arthritis research and public health, and for other 
purposes, having considered the same, report favorably thereon 
with an amendment and recommend that the bill as amended do 
pass.

                                CONTENTS

                                                                   Page
Amendment........................................................     1
Purpose and Summary..............................................     4
Background and Need for Legislation..............................     4
Committee Consideration..........................................     4
Committee Votes..................................................     5
Committee Oversight Findings and Recommendations.................     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Statement of General Performance Goals and Objectives............     5
Constitutional Authority Statement...............................     5
Earmarks and Tax and Tariff Benefits.............................     5
Federal Advisory Committee Statement.............................     5
Applicability of Law to the Legislative Branch...................     5
Federal Mandates Statement.......................................     6
Committee Cost Estimate..........................................     6
Congressional Budget Office Cost Estimate........................     6
Section-by-Section Analysis of the Legislation...................     7
Explanation of Amendment.........................................     8
Changes in Existing Law Made by the Bill, as Reported............     8

                               Amendment

  The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Arthritis Prevention, Control, and 
Cure Act of 2010''.

SEC. 2. ENHANCING PUBLIC HEALTH ACTIVITIES RELATED TO ARTHRITIS THROUGH 
                    THE NATIONAL ARTHRITIS ACTION PLAN.

  Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 314 the following:

``SEC. 315. NATIONAL ARTHRITIS ACTION PLAN.

  ``(a) Establishment of Plan.--The Secretary may develop and implement 
a National Arthritis Action Plan (in this section referred to as the 
`Plan') consistent with this section.
  ``(b) Control, Prevention, and Surveillance.--
          ``(1) In general.--Under the Plan, the Secretary may, 
        directly or through competitive grants to eligible entities, 
        conduct, support, and promote the coordination of research, 
        investigations, demonstrations, training, and studies relating 
        to the control, prevention, and surveillance of arthritis and 
        other rheumatic diseases.
          ``(2) Training and technical assistance.--
                  ``(A) Provision.--Upon the request of an applicant 
                receiving a grant under paragraph (1), the Secretary 
                may, subject to subparagraph (B), provide training, 
                technical assistance, supplies, equipment, or services 
                for the purpose of aiding the applicant in carrying out 
                grant activities and, for such purpose, may detail to 
                the applicant any officer or employee of the Department 
                of Health and Human Services.
                  ``(B) Corresponding reduction in payments.--With 
                respect to a request described in subparagraph (A), the 
                Secretary shall reduce the amount of payments under the 
                grant under paragraph (1) to the applicant involved by 
                an amount equal to the costs of detailing personnel 
                (including pay, allowances, and travel expenses) and 
                the fair market value of any supplies, equipment, or 
                services provided by the Secretary.
          ``(3) Arthritis prevention research at the centers for 
        disease control and prevention.--The Secretary may provide 
        additional grant support under this subsection to encourage the 
        expansion of research related to the prevention and management 
        of arthritis at the Centers for Disease Control and Prevention.
          ``(4) Eligible entity.--For purposes of this subsection, the 
        term `eligible entity' means a public or private nonprofit 
        entity that demonstrates to the satisfaction of the Secretary, 
        in the application described in subsection (e), the ability of 
        the entity to carry out the activities described in paragraph 
        (1).
  ``(c) Education and Outreach.--
          ``(1) In general.--Under the Plan, the Secretary may 
        coordinate and carry out national education and outreach 
        activities, directly or through the provision of grants to 
        eligible entities, to support, develop, and implement education 
        initiatives and outreach strategies appropriate for arthritis 
        and other rheumatic diseases.
          ``(2) Initiatives and strategies.--Initiatives and strategies 
        implemented under paragraph (1) may include public awareness 
        campaigns, public service announcements, and community 
        partnership workshops, as well as programs targeted to 
        businesses and employers, managed care organizations, and 
        health care providers.
          ``(3) Priority.--In carrying out paragraph (1), the 
        Secretary--
                  ``(A) may emphasize prevention, early diagnosis, and 
                appropriate management of arthritis, and opportunities 
                for effective patient self-management; and
                  ``(B) may give priority to reaching high-risk or 
                underserved populations.
          ``(4) Collaboration.--In carrying out this subsection, the 
        Secretary shall consult and collaborate with stakeholders from 
        the public, private, and nonprofit sectors with expertise 
        relating to arthritis control, prevention, and treatment.
          ``(5) Eligible entity.--For purposes of this subsection, the 
        term `eligible entity' means a public or private nonprofit 
        entity that demonstrates to the satisfaction of the Secretary, 
        in the application described in subsection (e), the ability of 
        the entity to carry out the activities described in paragraph 
        (1).
  ``(d) Comprehensive State Grants.--
          ``(1) In general.--Under the Plan, the Secretary may award 
        grants to eligible entities to provide support for 
        comprehensive arthritis control and prevention programs and to 
        enable such entities to provide public health surveillance, 
        prevention, and control activities related to arthritis and 
        other rheumatic diseases.
          ``(2) Application.--The Secretary may only award a grant 
        under this subsection to an eligible entity that submits to the 
        Secretary an application at such time, in such manner, and 
        containing such agreements, assurances, and information as the 
        Secretary may require, including a comprehensive arthritis 
        control and prevention plan that--
                  ``(A) is developed with the advice of stakeholders 
                from the public, private, and nonprofit sectors that 
                have expertise relating to arthritis control, 
                prevention, and treatment that increase the quality of 
                life and decrease the level of disability;
                  ``(B) is intended to reduce the morbidity of 
                arthritis, with priority on preventing and controlling 
                arthritis in at-risk populations and reducing 
                disparities in arthritis prevention, diagnosis, 
                management, and quality of care in underserved 
                populations;
                  ``(C) describes the arthritis-related services and 
                activities to be undertaken or supported by the entity; 
                and
                  ``(D) demonstrates the relationship the entity has 
                with the community and local entities and how the 
                entity plans to involve such community and local 
                entities in carrying out the activities described in 
                paragraph (1).
          ``(3) Use of funds.--An eligible entity may use amounts 
        received under a grant awarded under this subsection to 
        conduct, in a manner consistent with the comprehensive 
        arthritis control and prevention plan submitted by the entity 
        in the application under paragraph (2)--
                  ``(A) public health surveillance and epidemiological 
                activities relating to the prevalence of arthritis and 
                assessment of disparities in arthritis prevention, 
                diagnosis, management, and care;
                  ``(B) public information and education programs; and
                  ``(C) education, training, and clinical skills 
                improvement activities for health professionals, 
                including allied health personnel.
          ``(4) Eligible entity.--For purposes of this subsection, the 
        term `eligible entity' means a State or an Indian tribe.
  ``(e) General Application.--The Secretary may only award a grant 
under subsection (b) or (c) to an entity that submits to the Secretary 
an application at such time, in such manner, and containing such 
agreements, assurances, and information as the Secretary may require, 
including a description of how funds received under a grant awarded 
under such subsection will supplement or fulfill unmet needs identified 
in a comprehensive arthritis control and prevention plan of the entity.
  ``(f) Definitions.--For purposes of this section:
          ``(1) Indian tribe.--The term `Indian tribe' has the meaning 
        given such term in section 4(e) of the Indian Self-
        Determination and Education Assistance Act.
          ``(2) State.--The term `State' means any of the 50 States, 
        the District of Columbia, the Commonwealth of Puerto Rico, the 
        Virgin Islands, American Samoa, Guam, and the Northern Mariana 
        Islands.
  ``(g) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section--
          ``(1) for fiscal year 2012, $14,600,000;
          ``(2) for fiscal year 2013, $16,000,000;
          ``(3) for fiscal year 2014, $17,700,000;
          ``(4) for fiscal year 2015, $19,400,000; and
          ``(5) for fiscal year 2016, $21,400,000.''.

SEC. 3. ACTIVITIES OF THE DEPARTMENT OF HEALTH AND HUMAN SERVICES WITH 
                    RESPECT TO JUVENILE ARTHRITIS AND RELATED 
                    CONDITIONS.

  Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et 
seq.) is amended by adding at the end the following:

``SEC. 409K. JUVENILE ARTHRITIS AND RELATED CONDITIONS.

  ``(a) In General.--The Secretary, in coordination with the Director 
of NIH, may expand and intensify programs of the National Institutes of 
Health with respect to research and related activities designed to 
improve the outcomes and quality of life for children with arthritis 
and other rheumatic diseases.
  ``(b) Coordination.--The Director of NIH may coordinate the programs 
referred to in subsection (a) and consult with additional Federal 
officials, voluntary health associations, medical professional 
societies, and private entities, as appropriate.''.

SEC. 4. INVESTMENT IN TOMORROW'S PEDIATRIC RHEUMATOLOGISTS.

  Subpart I of part C of title VII of the Public Health Service Act (42 
U.S.C. 293k et seq.) is amended by adding at the end the following:

``SEC. 749A-1. PEDIATRIC RHEUMATOLOGISTS.

  ``In order to ensure an adequate future supply of pediatric 
rheumatologists, the Secretary, in consultation with the Administrator 
of the Health Resources and Services Administration, may award 
institutional training grants to institutions to support pediatric 
rheumatology training.''.

                          Purpose and Summary

    H.R. 1210, the ``Arthritis Prevention, Control, and Cure 
Act'', was introduced on February 26, 2009, by Representative 
Anna G. Eshoo (D-CA), and referred to the Committee on Energy 
and Commerce.
    The goal of H.R. 1210 is to provide for arthritis public 
health efforts, enhance juvenile arthritis research, and 
increase the number of pediatric rheumatology professionals.

                  Background and Need for Legislation

    Arthritis encompasses more than 100 diseases and conditions 
that affect joints, the surrounding tissues, and other 
connective tissues. Arthritis affects nearly one of every six 
Americans and it is the leading cause of disability in this 
nation.\1\
---------------------------------------------------------------------------
    \1\Arthritis Foundation, Association of State and Territorial 
Health Officials, and the Centers for Disease Control and Prevention, 
National Arthritis Action Plan: A Public Health Strategy (1999).
---------------------------------------------------------------------------
    The arthritis program at the Centers for Disease Control 
and Prevention (CDC) supports programs to implement the 1999 
National Arthritis Action Plan, but these activities are not 
specifically authorized.
    A 2007 report by the Health Resources and Services 
Administration (HRSA) concluded that there is a shortage of 
pediatric rheumatologists and that a 75% increase in such 
physicians is needed.\2\ Under the Patient Protections and 
Affordable Care Act (Public Law 111-148), HRSA is authorized to 
create loan repayment programs for pediatric subspecialists, 
which includes pediatric rheumatologists, but is unclear 
whether any authority currently exists under which HRSA could 
provide institutional training grants for pediatric 
rheumatologists.
---------------------------------------------------------------------------
    \2\Health Resources and Services Administration, Report to 
Congress: The Pediatric Rheumatology Workforce: A Study of the Supply 
and Demand for Pediatric Rheumatologists (Feb. 2007).
---------------------------------------------------------------------------

                        Committee Consideration

    H.R. 1210, the ``Arthritis Prevention, Control, and Cure 
Act'', was introduced by Ms. Eshoo of California on February 
26, 2009, and referred to the Committee on Energy and Commerce. 
The bill was subsequently referred to the Subcommittee on 
Health on March 2, 2009. On September 15, 2010, the 
Subcommittee held a legislative hearing on the bill. There was 
no Subcommittee markup held on the legislation.
    On September 23, 2010, the Committee on Energy and Commerce 
met in open markup session and discharged H.R. 1210 from the 
Subcommittee on Health in order to consider the bill in full 
Committee. Ms. Eshoo of California offered an amendment in the 
nature of a substitute (manager's amendment) to H.R. 1210, 
which was adopted by a voice vote. Subsequently the Committee 
ordered H.R. 1210 favorably reported to the House, amended, by 
a voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. A 
motion by Mr. Pallone ordering H.R. 1210 reported to the House, 
amended, was approved by a voice vote. There were no record 
votes taken during consideration of this bill.

            Committee Oversight Findings and Recommendations

    In compliance with clause 3(c)(1) of rule XIII and clause 
2(b)(1) of rule X of the Rules of the House of Representatives, 
the oversight findings and recommendations of the House are 
reflected in the descriptive portions of this report, including 
the finding that there is a shortage of pediatric 
rheumatologists and that an increase in such physicians is 
needed.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    Regarding compliance with clause 3(c)(2) of rule XIII of 
the Rules of the House of Representatives, the Committee finds 
that H.R. 1210 would result in no new budget authority, 
entitlement authority, or tax expenditures or revenues.

         Statement of General Performance Goals and Objectives

    In accordance with clause 3(c)(4) of rule XIII of the Rules 
of the House of Representatives, the performance goals and 
objectives of the Committee are reflected in the descriptive 
portions of this report, including the goal of providing for 
arthritis public health efforts, enhancing juvenile arthritis 
research, and increasing the number of pediatric rheumatology 
professionals.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
constitutional authority for H.R. 1210 is provided under 
article I, section 8, clauses 3 and 18 of the Constitution of 
the United States.

                  Earmarks and Tax and Tariff Benefits

    H.R. 1210 does not contain any congressional earmarks, 
limited tax benefits, or limited tariff benefits as defined in 
clause 9 of rule XXI of the Rules of the House of 
Representatives.

                  Federal Advisory Committee Statement

    The Committee finds that the legislation does not establish 
or authorize the establishment of an advisory committee within 
the definition of 5 U.S.C. App., section 5(b) of the Federal 
Advisory Committee Act.

             Applicability of Law to the Legislative Branch

    Section 102(b)(3) of Public Law 104-1 requires a 
description of the application of this bill to the legislative 
branch where the bill relates to terms and conditions of 
employment or access to public services and accommodations. 
H.R. 1210 contains no such provisions.

                       Federal Mandates Statement

    Section 423 of the Congressional Budget and Impoundment 
Control Act of 1974 (as amended by section 101(a)(2) of the 
Unfunded Mandates Reform Act, Public Law 104-4) requires a 
statement on whether the provisions of the report include 
unfunded mandates. In compliance with this requirement the 
Committee adopts as its own the analysis of federal mandates 
prepared by the Director of the Congressional Budget Office 
regarding H.R. 1210.

                        Committee Cost Estimate

    Pursuant to clause 3(d)(2) of rule XIII of the Rules of the 
House of Representatives, the Committee adopts as its own the 
cost estimate of H.R. 1210 prepared by the Director of the 
Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

               Congressional Budget Office Cost Estimate

    With respect to the requirements of clause 3(c)(3) of rule 
XIII of the Rules of the House of Representatives and section 
402 of the Congressional Budget Act of 1974, the Committee has 
received the following cost estimate for H.R. 1210 from the 
Director of Congressional Budget Office:

                                     U.S. Congress,
                               Congressional Budget Office,
                                Washington, DC, September 27, 2010.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1210, the 
Arthritis Prevention, Control, and Cure Act of 2010.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Mindy Cohen.
            Sincerely,
                                      Douglas W. Elmendorf,
                                                          Director.
    Enclosure.

H.R. 1210--Arthritis Prevention, Control, and Cure Act of 2010

    Summary: H.R. 1210 would authorize the Secretary of Health 
and Human Services to fund activities relating to the control, 
prevention, and surveillance of arthritis and other rheumatic 
diseases. Assuming appropriation of the specified amounts, CBO 
estimates that implementing H.R. 1210 would cost $52 million 
over the 2011-2015 period. Enacting H.R. 1210 would not affect 
direct spending or revenues; therefore, pay-as-you-go 
procedures do not apply.
    H.R. 1210 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary impact of H.R. 1210 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                               By fiscal year, in millions of dollars--
                                                    ------------------------------------------------------------
                                                       2011      2012      2013      2014      2015    2011-2015
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATIONAuthorization Level................................         0        15        16        18        19         68
Estimated Outlays..................................         0         5        13        16        18         52
----------------------------------------------------------------------------------------------------------------

    Basis of estimate: H.R. 1210 would authorize the Secretary 
of Health and Human Services, in coordination with the Center 
for Disease Control and Prevention, to award grants to public 
or private nonprofit entities for research, training, and other 
activities relating to the control, prevention, and 
surveillance of arthritis and other rheumatic diseases. The 
bill also would authorize the Director of the National 
Institutes of Health to expand and intensify programs designed 
to improve the outcome and quality of life for children with 
arthritis. In addition, the bill would authorize the Health 
Resources and Services Administration to award training grants 
to institutions to support pediatric rheumatology training.
    H.R. 1210 would authorize the appropriation of $68 million 
for fiscal years 2012 through 2015 and an additional $21 
million for fiscal year 2016. Based on historical spending 
patterns for similar activities, and assuming appropriation of 
the specified amounts, CBO estimates that implementing H.R. 
1210 would cost $52 million over the 2011-2015 period and an 
additional $37 million after 2015.
    Pay-As-You-Go considerations: None.
    Intergovernmental and private-sector impact: H.R. 1210 
contains no intergovernmental or private-sector mandates as 
defined in UMRA. Grant activities authorized in the bill would 
benefit state, local, and tribal governments.
    Estimate prepared by: Federal Costs: Mindy Cohen; Impact on 
State, Local, and Tribal Governments: Lisa Ramirez-Branum; 
Impact on the Private Sector: Sarah Axeen.
    Estimate approved by: Holly Harvey, Deputy Assistant 
Director for Budget Analysis.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that this Act may be cited as the 
``Arthritis Prevention, Control, and Cure Act of 2010''.

Section 2. Enhancing public health activities related to arthritis 
        through the National Arthritis Action Plan

    Section 2 authorizes the Secretary of Health and Human 
Services (Secretary) to develop and implement a National 
Arthritis Action Plan, at a level of $14.6 million in FY2012, 
rising to $21.4 million in FY2016. Such Plan would support 
arthritis control, prevention, surveillance, research, 
education, and outreach activities, through grants and direct 
support to public or private non-profit entities and states.

Section 3. Activities of the Department of Health and Human Services 
        with respect to juvenile arthritis and related conditions

    Section 3 authorizes the Secretary to expand and intensify 
programs of the National Institutes of Health (NIH) with 
respect to research and related activities concerning various 
forms of juvenile arthritis and related conditions.

Section 4. Investment in tomorrow's pediatric rheumatologists

    Section 4 authorizes the Secretary to provide grants to 
training institutions in order to support pediatric 
rheumatology training.

                        Explanation of Amendment

    During full Committee consideration of H.R. 1210, Ms. Eshoo 
of California offered an amendment in the nature of a 
substitute (manager's amendment), which was adopted by a voice 
vote. The substance of the substitute amendment is reflected in 
the section-by-section analysis contained in this report.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



SEC. 315. NATIONAL ARTHRITIS ACTION PLAN.

  (a) Establishment of Plan.--The Secretary may develop and 
implement a National Arthritis Action Plan (in this section 
referred to as the ``Plan'') consistent with this section.
  (b) Control, Prevention, and Surveillance.--
          (1) In general.--Under the Plan, the Secretary may, 
        directly or through competitive grants to eligible 
        entities, conduct, support, and promote the 
        coordination of research, investigations, 
        demonstrations, training, and studies relating to the 
        control, prevention, and surveillance of arthritis and 
        other rheumatic diseases.
          (2) Training and technical assistance.--
                  (A) Provision.--Upon the request of an 
                applicant receiving a grant under paragraph 
                (1), the Secretary may, subject to subparagraph 
                (B), provide training, technical assistance, 
                supplies, equipment, or services for the 
                purpose of aiding the applicant in carrying out 
                grant activities and, for such purpose, may 
                detail to the applicant any officer or employee 
                of the Department of Health and Human Services.
                  (B) Corresponding reduction in payments.--
                With respect to a request described in 
                subparagraph (A), the Secretary shall reduce 
                the amount of payments under the grant under 
                paragraph (1) to the applicant involved by an 
                amount equal to the costs of detailing 
                personnel (including pay, allowances, and 
                travel expenses) and the fair market value of 
                any supplies, equipment, or services provided 
                by the Secretary.
          (3) Arthritis prevention research at the centers for 
        disease control and prevention.--The Secretary may 
        provide additional grant support under this subsection 
        to encourage the expansion of research related to the 
        prevention and management of arthritis at the Centers 
        for Disease Control and Prevention.
          (4) Eligible entity.--For purposes of this 
        subsection, the term ``eligible entity'' means a public 
        or private nonprofit entity that demonstrates to the 
        satisfaction of the Secretary, in the application 
        described in subsection (e), the ability of the entity 
        to carry out the activities described in paragraph (1).
  (c) Education and Outreach.--
          (1) In general.--Under the Plan, the Secretary may 
        coordinate and carry out national education and 
        outreach activities, directly or through the provision 
        of grants to eligible entities, to support, develop, 
        and implement education initiatives and outreach 
        strategies appropriate for arthritis and other 
        rheumatic diseases.
          (2) Initiatives and strategies.--Initiatives and 
        strategies implemented under paragraph (1) may include 
        public awareness campaigns, public service 
        announcements, and community partnership workshops, as 
        well as programs targeted to businesses and employers, 
        managed care organizations, and health care providers.
          (3) Priority.--In carrying out paragraph (1), the 
        Secretary--
                  (A) may emphasize prevention, early 
                diagnosis, and appropriate management of 
                arthritis, and opportunities for effective 
                patient self-management; and
                  (B) may give priority to reaching high-risk 
                or underserved populations.
          (4) Collaboration.--In carrying out this subsection, 
        the Secretary shall consult and collaborate with 
        stakeholders from the public, private, and nonprofit 
        sectors with expertise relating to arthritis control, 
        prevention, and treatment.
          (5) Eligible entity.--For purposes of this 
        subsection, the term ``eligible entity'' means a public 
        or private nonprofit entity that demonstrates to the 
        satisfaction of the Secretary, in the application 
        described in subsection (e), the ability of the entity 
        to carry out the activities described in paragraph (1).
  (d) Comprehensive State Grants.--
          (1) In general.--Under the Plan, the Secretary may 
        award grants to eligible entities to provide support 
        for comprehensive arthritis control and prevention 
        programs and to enable such entities to provide public 
        health surveillance, prevention, and control activities 
        related to arthritis and other rheumatic diseases.
          (2) Application.--The Secretary may only award a 
        grant under this subsection to an eligible entity that 
        submits to the Secretary an application at such time, 
        in such manner, and containing such agreements, 
        assurances, and information as the Secretary may 
        require, including a comprehensive arthritis control 
        and prevention plan that--
                  (A) is developed with the advice of 
                stakeholders from the public, private, and 
                nonprofit sectors that have expertise relating 
                to arthritis control, prevention, and treatment 
                that increase the quality of life and decrease 
                the level of disability;
                  (B) is intended to reduce the morbidity of 
                arthritis, with priority on preventing and 
                controlling arthritis in at-risk populations 
                and reducing disparities in arthritis 
                prevention, diagnosis, management, and quality 
                of care in underserved populations;
                  (C) describes the arthritis-related services 
                and activities to be undertaken or supported by 
                the entity; and
                  (D) demonstrates the relationship the entity 
                has with the community and local entities and 
                how the entity plans to involve such community 
                and local entities in carrying out the 
                activities described in paragraph (1).
          (3) Use of funds.--An eligible entity may use amounts 
        received under a grant awarded under this subsection to 
        conduct, in a manner consistent with the comprehensive 
        arthritis control and prevention plan submitted by the 
        entity in the application under paragraph (2)--
                  (A) public health surveillance and 
                epidemiological activities relating to the 
                prevalence of arthritis and assessment of 
                disparities in arthritis prevention, diagnosis, 
                management, and care;
                  (B) public information and education 
                programs; and
                  (C) education, training, and clinical skills 
                improvement activities for health 
                professionals, including allied health 
                personnel.
          (4) Eligible entity.--For purposes of this 
        subsection, the term ``eligible entity'' means a State 
        or an Indian tribe.
  (e) General Application.--The Secretary may only award a 
grant under subsection (b) or (c) to an entity that submits to 
the Secretary an application at such time, in such manner, and 
containing such agreements, assurances, and information as the 
Secretary may require, including a description of how funds 
received under a grant awarded under such subsection will 
supplement or fulfill unmet needs identified in a comprehensive 
arthritis control and prevention plan of the entity.
  (f) Definitions.--For purposes of this section:
          (1) Indian tribe.--The term ``Indian tribe'' has the 
        meaning given such term in section 4(e) of the Indian 
        Self-Determination and Education Assistance Act.
          (2) State.--The term ``State'' means any of the 50 
        States, the District of Columbia, the Commonwealth of 
        Puerto Rico, the Virgin Islands, American Samoa, Guam, 
        and the Northern Mariana Islands.
  (g) Authorization of Appropriations.--There are authorized to 
be appropriated to carry out this section--
          (1) for fiscal year 2012, $14,600,000;
          (2) for fiscal year 2013, $16,000,000;
          (3) for fiscal year 2014, $17,700,000;
          (4) for fiscal year 2015, $19,400,000; and
          (5) for fiscal year 2016, $21,400,000.

           *       *       *       *       *       *       *


TITLE IV--NATIONAL RESEARCH INSTITUTES

           *       *       *       *       *       *       *


Part B--General Provisions Respecting National Research Institutes

           *       *       *       *       *       *       *


SEC. 409K. JUVENILE ARTHRITIS AND RELATED CONDITIONS.

  (a) In General.--The Secretary, in coordination with the 
Director of NIH, may expand and intensify programs of the 
National Institutes of Health with respect to research and 
related activities designed to improve the outcomes and quality 
of life for children with arthritis and other rheumatic 
diseases.
  (b) Coordination.--The Director of NIH may coordinate the 
programs referred to in subsection (a) and consult with 
additional Federal officials, voluntary health associations, 
medical professional societies, and private entities, as 
appropriate.

           *       *       *       *       *       *       *


TITLE VII--HEALTH PROFESSIONS EDUCATION

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PART C--TRAINING IN FAMILY MEDICINE, GENERAL INTERNAL MEDICINE, GENERAL 
  PEDIATRICS, PHYSICIAN ASSISTANTS, GENERAL DENTISTRY, AND PEDIATRIC 
                               DENTISTRY

Subpart I--Medical Training Generally

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SEC. 749A-1. PEDIATRIC RHEUMATOLOGISTS.

  In order to ensure an adequate future supply of pediatric 
rheumatologists, the Secretary, in consultation with the 
Administrator of the Health Resources and Services 
Administration, may award institutional training grants to 
institutions to support pediatric rheumatology training.

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